Susan Grover, N.P.P., C.S

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

F400636-1 Issued in NY

Practice address

1050 Hallock Ave., Suite 4
Port Jefferson Station, NY 11776

Phone

(631) 886-1194

Fax

(631) 929-3039

NPI assigned

Feb 20, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1558406660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "658 SOUND AVE., F11",
            "city": "CALVERTON",
            "state": "NY",
            "postal_code": "119331049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 HALLOCK AVE., SUITE 4",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "11776",
            "telephone_number": "631-886-1194",
            "fax_number": "631-929-3039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROVER",
        "first_name": "SUSAN",
        "credential": "N.P.P., C.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F400636-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keriann Marie Greehy, LPN
• Karen Greenwood, M.S.W.
• Gregory J Diehl MD PC
• Salema Shirelle Griffith
• Veronica A Groth, N.P.P
• Rebekah Guastella, M.S., CF-SLP, TSSLD
• Adriana Guigova, DO
• Jin Guo
• Deepti Gupta, M.D.
• Nipun Gupta

• Psychiatric/Mental Health Nurse Practitioner in Port Jefferson Station, NY
• Providers in Port Jefferson Station, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.